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COPD treatment case II: COPD with asthma as child
Published on February 29, 2016 13 min
A selection of talks on Respiratory Diseases
Molecular epidemiology of lung cancer
- Prof. David Christiani
- Harvard School of Public Health and Harvard Medical School, USA
CompEx asthma: a novel composite exacerbation endpoint
- Dr. Carla A. Da Silva
- AstraZeneca, Sweden
Hi. This is the second of the COPD treatment cases. I'm Janwillem Kocks. I'm a general practitioner and an assistant professor at the Department of General Practice at the University Medical Center in Groningen in the Netherlands. And this case will be about a COPD patient with asthma.
So we start with Mrs. D again. She's a 59-year-old lady and works in a community archive. And she tells you that she noticed that while carrying boxes with books and stuff has become more difficult in the last months. And you see her for the annual review, which you do for COPD. If you look at the lung function, it's quite stable in the last years, with an FEV1 of 74% of predicted, and a FEV1/FVC of 60%. She tells you she had a course of antibiotics for a lung attack last month in the out-of-hours GP service. You can question if antibiotics is the best treatment option, but this is what she tells you. She stopped smoking four weeks ago after about 30 years of smoking, and it adds up to 35 pack years. She's got a BMI of 27.8 and a CCQ score of 1.8. And the medication she uses is ipratropium short-acting, a muscarinic antagonist. And last week she's been using that for about three times a day during her work and when walking with friends. Next is she uses tiotropium one times a day. And if you go back to her and talk to her a bit longer about her history she had with her lung complains, she says she was admitted to a rehabilitation service for her CARA, as she calls it in Dutch, when she was seven. The Dutch rehabilitation center for asthma in Davos, Switzerland. It's nice, high in the mountains which makes it less of a host of mites and other things that is bad for young asthma patients. And it's still in use for asthma patients. So that's an important new information, and it's different from the information we had for the previous case. And as she completed the CCQ questionnaire.